A government program that keeps an eye on hospital readmission numbers penalized St. James Healthcare starting this fall, impacting its financial picture.
The Butte-based hospital was one of nine Montana health care facilities hit with the penalty, which went into effect Oct. 1. St. James expects to lose $52,000 as a result of the penalty, said Jay Doyle, St. James Healthcare president through an email.
“St. James will see a .33% reduction in Medicare reimbursements, which is less than half of the national average of .71%,” Doyle wrote through email.
The Medicare program under the Hospital Readmission Reduction Program links Medicare payments to the hospital’s quality of care to try to improve it.
St. James is not alone. In addition to the other Montana hospitals also hit with the penalty, The Bozeman Chronicle previously reported that of the 3,129 hospitals evaluated across the nation, 83% got a penalty hit.
The program looks at heart and lung diseases and hip and knee replacement surgeries and readmissions within a month of care.
Doyle said through email that St. James is “committed to continuously seeking ways to reduce readmissions.”
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He said that when a patient first arrives, he or she gets a “care team” made up of providers, nurses and case managers. The care team works with the patient, plus family members and various facilities the patient might land in after surgery.
The care team also schedules follow-up appointments and various types of therapy and education if the patient needs it.
“These are just a few of the ways we can extend our care beyond our four walls to ensure once we discharge a patient they have what they need to continue with their follow-up care and promote long-term healing and wellness,” Doyle wrote.
The Hospital Readmission Reduction Program came about because of the Affordable Care Act, more commonly known as “Obamacare.”
Bob Olsen, senior vice president of the Montana Hospital Association, told the Chronicle that in the last fiscal year, Montana lost $590,000 due to Medicare penalties. But this year, the overall cut is expected to be much lower at $260,000.
Montana hospitals will see $600,000 in bonus payments for improving the quality of care, according to association estimates.
“While we continue to work to improve our processes around post-hospitalization care, we continue to make a determination on whether a patient should be readmitted on the needs and condition of the individual patient,” Doyle wrote.